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International Orthopaedics

, Volume 43, Issue 7, pp 1659–1667 | Cite as

Significant improvement in patient self-assessed comfort and function at six weeks after the smooth and move procedure for shoulders with irreparable rotator cuff tears and retained active elevation

  • Frederick A. MatsenIIIEmail author
  • Anastasia Whitson
  • Sarah E. Jackins
  • Jason E. Hsu
Original Paper
  • 76 Downloads

Abstract

Background

It has been documented that the smooth and move procedure—smoothing the proximal humeral surface while maintaining the coracoacromial arch—can provide clinically significant long-term improvement in function for patients having irreparable rotator cuff tears with retained active elevation. This study sought to demonstrate that clinically significant gains in comfort, function, and active motion can be realized as early as 6 weeks after this procedure.

Methods

We conducted a prospective cohort study of the 6-week clinical outcomes for 48 patients enrolled prior to a smooth and move procedure for irreparable rotator cuff tears. Prior rotator cuff repair had been attempted in 28 (70%).

Results

In 40 patients with preoperative and 6-week postoperative measurements, the Simple Shoulder Test scores improved from an average of 3.4 ± 2.8 preoperatively to 5.7 ± 3.5 at 6 weeks (p < 0.001), an improvement that exceeded the published values for the minimal clinically important difference (MCID). The clinical outcomes were not worse for the 18 shoulders with irreparable tears of both the supraspinatus and infraspinatus. In 30 patients with preoperative and 6-week postoperative objective measurements of active motion, the average abduction improved from 93(± 43) to 123(± 47)° (p = 0.005) and the average flexion improved from 102(± 46) to 126(± 44)° (p = 0.023).

Conclusions

In addition to its previously documented long-term effectiveness for shoulders with irreparable rotator cuff tears and retained active elevation, this study demonstrates that the smooth and move procedure provides clinically significant improvement as early as 6 weeks after surgery.

Keywords

Irreparable rotator cuff tear Smooth and move procedure Clinical outcomes Active abduction Active flexion 

Notes

Acknowledgements

We thank Susan DeBartolo, University of Washington, Department of Orthopaedics and Sports Medicine, for her editorial work on this manuscript.

Compliance with ethical standards

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This was a Level II prospective cohort study approved by our Institutional Review Board (STUDY00004686). For this type of study, formal consent is not required.

Informed consent

N/A.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© SICOT aisbl 2019

Authors and Affiliations

  1. 1.Department of Orthopaedics and Sports MedicineUniversity of Washington Medical CenterSeattleUSA
  2. 2.Department of RehabilitationUniversity of WashingtonSeattleUSA

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